Fungal skin infections

About fungal skin infections

Fungal skin infections usually affect your skin because they live off keratin, a protein that makes up your skin, hair and nails.

Fungal skin infections are divided into different groups depending on what type of fungus is involved.

Types of fungal skin infections

Some common fungal skin infections are listed below.

Dermatophyte infections

Athlete’s foot (Tinea pedis)

It’s estimated that one in six people in the UK currently have athlete’s foot. It’s caused by a fungus that makes your skin itchy, flaky and red, and causes white cracks to appear, especially between your toes and on the side of your foot. Occasionally it causes blisters. Athlete’s foot is often picked up from walking bare foot on damp, contaminated floors in communal shower facilities, swimming pools or saunas. If you don’t wash your hands after touching a contaminated area, it can spread to other parts of your body, including your groin and underarms. See our common questions for more information.

Nail infections (Tinea unguium)

These can occur on any part of your nail and take a long time to develop. They cause your nail to discolour and become crumbly. The surrounding tissue may also thicken. Toenails are usually affected more than fingernails. See our common questions for more information.

Ringworm of the groin (Tinea cruris)

This is also called ‘jock itch’ because it’s more common in people that play sports and young males. It’s contagious and can be passed from person to person by direct contact or contact with unwashed clothes. It can cause an itchy, red rash in your groin and the surrounding area. You may get ringworm of the groin if you have athlete’s foot and touch your groin after touching your foot without washing your hands.

Ringworm of the body (Tinea corporis)

This often affects exposed parts of your body, such as your arms, legs or face, and causes a red, ring-shaped rash. Ringworm is contagious and can be caught by coming into contact with somebody who already has ringworm or touching contaminated items, such as:

clothing

combs

swimming pool surfaces

shower floors and walls

Domesticated animals, such as sheep, cattle and pets (especially cats), can also carry the fungi that cause ringworm.

Ringworm of the body

Ringworm of the scalp (Tinea capitis)

This can occur at any age, but mostly affects children and goes away at puberty. Ringworm of the scalp can affect all of your scalp or only parts of it. Symptoms are similar to those of ringworm of the groin and ringworm of the body. You may also develop pus-filled areas on your scalp, called kerions, and have bald areas with small black dots due to your hair falling out. It can be caused by sharing a contaminated hat, comb or another piece of clothing being used by somebody with ringworm.

Yeast infections

Other fungal skin infections are caused by yeast infections. Yeast infections include the following.

Intertrigo

Intertrigo is a yeast infection of skin folds caused by the fungus Candida albicans, which can grow on your skin. It affects the top layers of your skin, where two skin surfaces press or rub together and can cause chaffing between two moist surfaces. This commonly affects people who are obese, people who have to stay in bed for long periods of time and people with artificial limbs, splints or braces. If your skin is affected, it will usually turn pink or brown and if it’s very moist, your skin can start to break down and have an unpleasant smell.

Pityriasis versicolor

This condition is caused by a type of fungus called Malassezia. It’s quite common and usually affects young adults after puberty. Your back, upper arms and torso may have patches of scaly, itchy and discoloured skin – usually pink, brown or red. If you have darker skin, it may lose some of its colour.

Thrush (Candida albicans)

C. albicans is a common fungus that is often present in your mouth, stomach and skin. It may also be present in your vagina if you’re a woman. You usually have no problems, but if you’re unwell, pregnant, have diabetes or taking antibiotics, the fungi can multiply, causing thrush symptoms.

Thrush infection often looks like small white patches, which leave a red mark when rubbed off. In women, vaginal thrush can cause itchiness and a white discharge that ranges from slightly watery to thick and white.

Thrush also commonly affects newborn babies in the mouth (oral thrush). The white patches may be mistaken for breast or formula milk. It isn't usually serious, but babies with thrush in their throats may stop feeding properly. Babies may also develop thrush in the nappy area.

Symptoms of fungal skin infections

The symptoms and appearance of a fungal skin infection depend on the type of fungus causing it and the part of your body affected.

Fungal skin infections can cause rashes with a variety of different appearances. Some are red, scaly and itchy. Others may produce a fine scale, similar to dry skin. The fungus can affect just one area or several areas of your body.

Fungal infections of your scalp can lead to hair loss. Fungal rashes are sometimes confused with other skin conditions, such as psoriasis and eczema.

If you think you have a fungal skin infection, see your GP for advice.

Causes of fungal skin infections

You’re more likely to get a fungal skin infection if you:

have recently taken a course of antibiotics

are pregnant

have poorly controlled diabetes

have a weakened immune system, for example, HIV/AIDS

are overweight

come into direct contact with another person or an animal that has a fungal skin infection

have indirect contact with items contaminated with a fungus, for example, clothes, towels and bedclothes

walk barefoot in shower and pool areas

don’t dry yourself after sweating or bathing

wear tight clothing that doesn’t allow sweat to evaporate

cut or graze the surface of your skin

Diagnosis of fungal skin infections

Your GP will usually diagnose fungal skin infections by looking at the appearance of your skin and the location of any rashes. Occasionally, a skin scraping or a fragment of your nail or hair will be sent to a laboratory for testing to confirm the diagnosis.

Treatment of fungal skin infections

You will usually need to use an antifungal treatment that you put directly onto the affected area of your skin. These are known as topical treatments.

There are a variety of treatments available in the form of creams, lotions, paints, shampoos and medicated powders. Some of these are available over-the-counter from a pharmacist, without prescription. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

If your rash covers a large area of your skin or affects your nails or scalp, you may need to take some tablets. Your GP may also prescribe you tablets if you have used a topical treatment that hasn’t worked.

Treatments for fungal skin infections are usually effective. They can occasionally cause side-effects, which include skin irritation and stomach problems. Your rash may return, even if it seems to have cleared up. Treatment should continue for up to two weeks after the rash disappears.

You may need to take some treatments for a few weeks, or up to 12 months for toenail infections.

If your GP has diagnosed a fungal skin infection, he or she will advise you to wash the affected area every day, making sure that you dry the area thoroughly, especially in the skin folds.

Prevention of fungal skin infections

There are some steps you can take to reduce your risk of getting a fungal skin infection and stop an infection from spreading. You should:

wear loose fitting clothes made of cotton to help move moisture away from your skin

not share towels, hair brushes and combs that could be carrying any fungi

alternate pairs of shoes every two or three days to give them time to dry out

keep your blood sugar under control if you have diabetes

soak pillows, hats, combs or scissors with bleach and water if someone in your family has scalp ringworm

Can herbal remedies, such as tea tree oil, help with fungal infections?

Answer

There isn’t currently enough scientific evidence to say whether or not herbal remedies can help to treat fungal infections.

Explanation

Some people who try herbal medicines, such as tea tree oil, to treat fungal infections find that they help. Early research has shown that tea tree oil may help against some types of fungi. However, there isn’t enough evidence to recommend using or not using tea tree oil to treat fungal infections.

You can try herbal remedies to help treat your fungal skin infection if you wish, but don’t delay seeking help from your pharmacist or GP.

You may find herbal remedies helpful, but it’s important to remember that natural doesn’t mean harmless. Herbal remedies contain active ingredients and may interact with other medicines or cause side-effects. Don’t start taking any herbal remedies without speaking to your GP or pharmacist first.

Will improving my foot hygiene get rid of my athlete's foot?

Answer

Improving your foot hygiene, such as washing and drying your feet thoroughly and making sure you change your socks or tights every day, will help to control an infection, but it won’t usually be enough to get rid of athlete’s foot.

Explanation

Some people can be cured of athlete’s foot without treatment and by improving their hygiene. This is rare and isn’t usually enough for everyone. It’s a good idea to make sure you carry out good hygiene anyway. This can prevent the infection spreading to other parts of your body, for example, your toenails and groin.

treating your feet with antifungal powder if you are susceptible to getting athlete’s foot

If I have a fungal nail infection, how long will it take for my nail to get back to normal?

Answer

It can take up to 12 months, but it will depend on whether it’s your fingernail or toenail that is affected and how well you respond to treatment.

Explanation

Treatment with antifungal medicines will usually get rid of your fungal nail infection. Your fingernails are more likely to get better with treatment than your toenails. However, treatment isn’t always able to cure your infection. If this happens, your GP may refer you to a dermatologist (a doctor who specialises in identifying and treating skin conditions) or podiatrist (a health professional who specialises in conditions that affect the feet) for assessment and treatment.

Treatments include painting your nail with a lotion that you can buy over-the-counter or antifungal tablets. Painting your nail works best if your infection is at an early stage, or if it’s done at the same time as taking tablets. Tablets often work better than treatments that you put on your nail, especially if the infection has taken over the whole nail. There are three types of tablets available that need to be taken over a long period of time, sometimes up to 18 months if the infection is bad.

It can take up to six months after treatment has begun for your fingernails to look normal again, and up to 12 months for your toenails. However, sometimes, the nail’s appearance doesn’t return to normal.

Fungal nail infections come back in about one in four people. This is more likely if you’re older, have thickened or damaged nails, or have a different nail disease.